Organization Active NPI

Pompton Lakes Pulmonary, P.C.

  • Pulmonary Disease Physician
  • Lincoln Park, NJ
National Provider Identifier
1568417210
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
POMPTON LAKES PULMONARY, P.C.
Practice address
63 Beaverbrook Rd Ste 301
Lincoln Park, NJ 07035-1440
Phone
(973) 694-1300
Fax
(973) 694-1399
NPI assigned
May 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Timothy O'Donnell, D.O.
Title
President
Phone
(973) 694-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X Primary

Addresses

Primary practice location

63 Beaverbrook Rd Ste 301
Lincoln Park, NJ 07035-1440

Mailing address

63 Beaverbrook Rd Ste 301
Lincoln Park, NJ 07035-1440
Phone (973) 694-1300

Other identifiers 1

IdentifierTypeStateIssuer
6836101MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1568417210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 BEAVERBROOK RD STE 301",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070351440",
            "telephone_number": "973-694-1300",
            "fax_number": "973-694-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 BEAVERBROOK RD STE 301",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070351440",
            "telephone_number": "973-694-1300",
            "fax_number": "973-694-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POMPTON LAKES PULMONARY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "O'DONNELL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-694-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6836101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.